Provider Demographics
NPI:1770082893
Name:PELCZAR, MARIA
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:PELCZAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PHEASANT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2116
Mailing Address - Country:US
Mailing Address - Phone:702-720-3726
Mailing Address - Fax:
Practice Address - Street 1:3097 E WARM SPRINGS RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3757
Practice Address - Country:US
Practice Address - Phone:702-720-3726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-04
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4693106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist